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Aggressive Behavior Incident Report Form
Name of Person completing this form:
Date of Report:
WHO was involved:
Victim(s):
Bully(ies):
Others who may have witnessed the incident or may have knowledge of the incident:
WHERE did the incident take place?
WHEN did the incident take place?
WHAT happened? (Please be as specific as possible) :
Thank you. This report will be followed up within 2 school/work days.
If you fear a student is in IMMEDIATE danger, please contact the police immediately!
Remember: False accusations of bullying or harassment will be subject to appropriate disciplinary action.